Measuring Respiratory Rate in Children

Respiratory rate is an important vital sign used in the initial and ongoing assessment of all children in hospital. It is also used as a predictor of serious deterioration in a patient's clinical condition. Measuring respiratory rate in children can be difficult to perform and time consuming, especially in an uncooperative child. Convenient electronic devices exist for the measurement of many of the vital signs yet no device is currently available that can give an accurate and rapid assessment of respiratory rate in clinical practice. In this thesis we have examined the current practices of local paediatric healthcare professionals in measuring respiratory rate and explored the levels of agreement that exist in measurements obtained. We have assessed the value of a respiratory rate measurement in detecting and identifying children at risk of clinical deterioration, comparing and contrasting it with the other vital signs. Finally we have developed a contactless portable respiratory rate monitor (CPRM) and evaluated the agreement in respiratory rate measurements between existing methods and our device. Our work has added considerably to the overall body of evidence regarding respiratory rate measurements in children. We have provided clear evidence that there are a large variety of practices used by paediatric healthcare professionals in measuring respiratory rate. We have shown an inherent variability in respiratory rate measurements between observers and firmly established that respiratory rate is a powerful predictor of clinical deterioration in children, superior to other vital signs. Finally we successfully measured respiratory rates in both adults and children using the CPRM. Our device offers a promising alternative to current methods. In its present form it does not appear accurate enough to be used in clinical practice, however plans are underway to develop the device further with revisions informed by the research in this thesis. A contactless device for accurately and quickly measuring respiratory rate could be an important tool in the assessment of unwell children in the near future.